Question

I am confused about my CD4 count and CD4%

8 December 2010. Related: All topics, CD4 and viral load, Newly diagnosed, Starting treatment.

Question:

Really confused over my low CD4 count but an ok CD4 percentage.

Hi, I was diagnosed in October 2007 and unfortunately a late presenter with a CD4 count of 03, Viral Load 54,000 and CD4 percentage of 1%.

Treatment Efavirenz and Abacavir/Lamivudine started immediately.

Over the last 3 years on this one treatment my VL has remained at less than 40copies, absolute CD4 count between 119-140 and CD4 percentage between 19-24%.

My question is with such a constant low CD4 count (119-140) why is my CD4 percentage (19-24%) doing ok, as read of others reporting having high CD4 counts 300-400 with these percentages?

Also, when I was diagnosed my VL was relatively low at 37,000 then 54,00 copies on the 2nd blood test, I don’t understand why the HIV destroyed my immune system so quickly to a CD4 of 03, as I often read of other people having VL in the millions.

My doctor also says that my CD4 count WILL NEVER go above 200 now

Answer

Answer: Winnie Sseruma

Thank you for your question.

I am sorry that you are so distressed about your CD4 count. My advice would be to stop focussing too much on these numbers.

CD4 count fluctuates a lot, anything going on in your immune system will affect it including the time of day when you take the CD4 count test. CD4% is more stable and that is why doctors rely on the CD4% in terms of gauging how you are doing. You CD4% is still quite good, be happy with that. Every individual is different and everyone responds  differently to treatment, so you can’t always compare yourself to how others are doing.

If you get diagnosed  with a low CD4 count then it is going to take quite sometime for it to go up even with treatment. It also depends very much on what your original CD4 count was before you became HIV positive. But unfortunately many of us do not know this. There are people I know who started off with a CD4 count of 1, over a decade ago, and now have a CD4 count of 600.